Washing test apparatus

ABSTRACT

Washing efficacy test apparatus ( 2 ) is provided which includes a holder ( 4 ) and a test soil device ( 6 ) for location with said holder ( 4 ). The test soil device ( 6 ) is in the form of sheet material with a test soil substance ( 34 ) provided thereon. The holder in one example includes two members ( 8, 10 ) between which the test soil device ( 6 ) is detachably attached so that the device ( 6 ) can be easily removed for inspection and maintained in a required orientation in the washing apparatus ( 2 ) in use.

This application is a divisional of U.S. application Ser. No.10/555,502, which is a national stage application under 35 U.S.C. §371from PCT Application No. PCT/GB2004/001875, filed Apr. 30, 2004, whichclaims the priority benefit of Great Britain Application No. 0310280.3,filed May 3, 2003.

FIELD OF THE INVENTION

This invention relates to washing/cleaning efficacy test apparatus, andparticularly but not necessarily exclusively to washing/cleaningefficacy test apparatus for clinical and/or laboratory use.

BACKGROUND OF THE INVENTION

Surgical instruments and other medical devices used for clinical orlaboratory purposes must be reprocessed or decontaminated after use, ifthey are non-disposable, in order to prevent infection and crosscontamination. The decontamination process typically involves 3 steps; awashing/cleaning step to remove blood, proteins and other bodilycontaminants from the instruments and/or devices, followed by adisinfection step to allow safe handling and inspection of thedevices/instruments prior to packaging, and the final step ofsterilisation. If the devices/instruments are sterilised withouteffective washing/cleaning or disinfection, sterilisation is likely tobe ineffective.

The cleaning/washing and disinfection steps are two distinct stages inthe decontamination process but are often undertaken in the same washingapparatus (a washer disinfector) in a sequential manner using differentprogrammable cycles. The efficacy of the disinfection step (a heatprocess) can be verified thermometrically but the efficacy of thewashing/cleaning step cannot be easily measured parametrically. As such,a test substance known as a “test soil” is used as a challenge in thewashing apparatus and includes a pre-determined level of contaminantsthereon, which is designed to simulate typical soiling of surgicalinstruments and medical devices during normal use. The “test soil” iscoated onto a selection of surgical instruments and/or medical devicesand is allowed to dry onto to the same for a period of time. Theinstruments and/or devices are then processed through the washingapparatus or washer disinfector to test the efficacy of thewashing/cleaning step. Removal of “test soil” from the instruments anddevices can be determined visually since most test soils contain bloodor dyes to make them visible. Alternatively, a chemical detection methodsuch as ninhydrin (1,2,3-indantrione monohydrate) can be used. Theninhydrin method utilises the reaction of amino acids, peptides andproteins with the ninhydrin to produce a highly coloured compound. Aselection of instruments are swabbed with water, then the swab istreated with ninhydrin. If protein is present on the instruments, i.e.if the instruments are not clean, the swab turns a purple colour.

Conventional test soils typically include animal blood or bloodfractions and other animal products, such as egg or egg fractions.However, the natural variability of the test soil components can meanthat the test soils may not perform consistently from batch to batch. Inaddition, the test soils need to be coated onto a range of instrumentsand allowed to dry for between 30 minutes to two hours prior to washing.This is time consuming and is typically a major inconvenience for busyhospital departments. There are also problems associated with theavailability of fresh test soil components and, due to the problemsmentioned above, the test is normally conducted on a periodic basiswhich, in some cases, is as infrequently as four times a year. As such,any problems which might arise with the washing process are onlyidentified infrequently. Furthermore, due to the well known risksassociated with using blood products, it is undesirable to use the samein the manner described above.

An example of a conventional test soil device which is used in themonitoring of the cleaning efficiency of washer disinfection apparatusincludes a standardised test soil substance which is placed at an amountof 20 mg on a small stainless steel plate. The test soil consists of 95%water soluble components and 5% water insoluble fibrin fibres whichcorrelates to coagulated human blood.

A problem associated with such a conventional test device is that it isgenerally uni-directional and is exposed to washing and cleaning in onedirection only. However, since the efficacy of the washing and cleaningprocesses is dependent on factors such as the operating cycle beingused, temperature and pressure of the water, the location of the testdevice in the washing apparatus, loading of the washing apparatus andwhether the test device is adjacent water/fluid jets in the washingapparatus, if only a single surface of the test device has a test soilsubstance provided thereon, it is unlikely to provide an accuraterepresentation of the efficacy of washing and cleaning of the washingapparatus.

It is therefore an aim of the present invention to provide washing testapparatus which removes the requirement for coating instruments with atest soil substance.

It is a further aim of the present invention to provide washing testapparatus which is quick and easy to use, thereby ensuring regular useof the apparatus.

It is a yet further aim of the present invention to provide washing testapparatus which provides a more accurate and multidirectional challengethat is representative of cleaning/washing efficacy in washingapparatus.

It is an aim of the present invention to provide holder means for usewith a test soil device.

It is a further aim of the present invention to provide a test soildevice for use with holder means.

SUMMARY OF THE INVENTION

According to a first aspect of the present invention there is providedwashing test apparatus, said apparatus including holder means and one ormore test soil devices for location with said holder means for allowinga washing process to be tested, said holder means including at leastfirst and second members, characterised in that at least a portion ofsaid first and/or second members is capable of undergoing relativemovement to allow said one or more test soil devices to be locatedtherebetween.

In one embodiment the at least first and second members are provided apre-determined small distance apart and the test soil device is locatedbetween the members in use. A portion of the test soil device typicallyprotrudes from the members when in position therebetween to allow thedevice to easily removed as required.

Preferably said at least first and second members are pivotally movablerelative to each other. For example, the first and second members can bejoined together via a hinge or pivot point.

The first and second members are movable between a first closedposition, wherein the members are parallel with and substantiallyadjacent to each other, and a second open position, wherein at least apart of the members are spaced apart from each other sufficiently toallow a test device to be inserted therebetween or removed therefrom.The test device is located between the members when in the closedposition in use and the members are arranged such that the test devicecannot fall out from between the members in said closed position.

In one embodiment the first and second members include a handle portionand a test soil device holding portion. The test soil device holdingportion is typically moved between said open and closed positions. Thehandle portion is typically gripped by a user to allow a user to movethe test soil device holding portion between said open and closedpositions.

Preferably the test soil device holding portion of one or more of saidfirst and/or second members includes two or more surfaces which allowthe attachment of one or more test soil devices thereto. The two or moresurfaces are typically located at different angles or are orientated indifferent directions, thereby providing multi-directional washing testapparatus. In addition, these different angled surfaces help to securethe test soil device between the first and second members.

Alternatively the test soil device holding portions are substantiallylinear or straight in form.

In one embodiment the two or more surfaces include opposing surfaces ofthe test soil device holding portion (i.e. surfaces of the first andsecond members).

In a further embodiment the two or more surfaces include surfacesprovided at an angle relative to each other on the first and/or secondmember. For example, in one example, the two or more surfaces areprovided substantially perpendicular to each other on each member.

Preferably at least the test soil holding portion, the surfaces to whichthe test soil device is attached or between which the test soil deviceis attached are provided with one or more apertures therein to increasethe exposure of the test soil device to washing fluid in the washingapparatus.

In one embodiment the apertures are provided in a grid like arrangement.

In a further embodiment the apertures are in the form of a mesh.

In either embodiment the provision of the aperture and walls of theholder means defining the apertures provides an open surface and arestricted surface for testing the efficacy of the washing process. Thisprovides a good representation of a typical item of surgical or medicalequipment, particularly hinged instruments such as scissors or forcepswhich are notoriously difficult to clean due to contaminants becomingtrapped within the joints of the said instruments.

Preferably the first and second members are resiliently biased to saidclosed position. The biasing force is sufficient to secure, at least inpart, the test soil device between the members in said closed position.

Further preferably the handle portion of the members is resilientlybiased to said closed position. In this position, the handle portions ofthe members are a spaced distance apart and the test soil holdingportions are parallel and adjacent each other.

A spring, sprung metal/plastic or other biasing means can be provided tobias the members/handle portion to said closed position.

The biasing means can also be the means by which the first and secondmembers are attached together.

In one embodiment the holder means and/or the test soil holding portionis any or any combination of substantially round, substantiallycylindrical, substantially semi-circular and/or any other requiredshape.

The first and second members and/or the test soil device holdingportions can taper if required.

In the embodiment wherein the holder means is cylindrical, the first andsecond member are also substantially cylindrical and the first outermember is of slightly larger dimensions than said second inner member.As such, the second member can be located in the channel defined by thecylindrical walls of said first member. The test soil device is locatedbetween the first and second members and one or more apertures can beprovided in the walls of the first and second members if required.

Preferably the one or more test soil devices are in the form of sheetmaterial with a test soil substance provided thereon.

Preferably the test soil substance or indicator provided on the testsoil device is printed onto a surface of the sheet material and furtherpreferably the test soil substance or indicator is printed onto bothsurfaces of the sheet material.

In providing the test soil substance on sheet material rather thancoating instruments or medical devices, the test soil is easier andsafer to handle. The test soil device is typically pre-prepared, therebyreducing the time required for a user to set up the test in washingapparatus. In addition, since the test soil device is detachablyattached to the holder it can be easily removed for inspection and ismaintained in a required orientation in the washing apparatus in use.

Preferably the sheet material is substantially flexible, therebyallowing the test soil device to be bent around angled first and/orsecond members, rolled up and located in channels or lumens of medicalor surgical instruments to ensure adequate cleaning of the same.

Preferably the sheet material is formed from a plastic material, such aspolypropylene.

The test soil substance or indicator does not include blood or bloodrelated products but can contain any or any combination of proteins(typically from at least two sources), lipids and/or polysacharrides.Each of the components of the indicator present a unique challenge tothe cleaning/washing process. For example, proteins require a cool washbelow 35 degrees celsius, whereas lipids require a higher temperature,preferably in the presence of a surfactant.

The indicator is provided in such a colour, by dye or other means toprovide a clear visual indication as to the presence of contaminantsthereon. If any residue is visible on the test device after washing, thetest indicates that the washing/cleaning process has failed to providean adequate cleaning/washing process. If no residue is visible on thetest device after washing, the test indicates that the washing processmeets the required criteria for cleaning/washing. The sheet material canbe transparent or opaque to allow easy visualisation of the indicatorthereon.

The degree to which the components of the indicator are adhered to thesurface of the sheet material can be varied as required, therebyreflecting the ability to remove normal contaminants which have beendried onto instruments for different periods of time.

According to a second independent aspect of the present invention thereis provided a test soil device for use with holder means.

The test soil device can be used independently of the holder means ifrequired.

According to a further independent aspect of the present invention thereis provided holder means for use with a test soil device.

Thus, it can be seen that the advantages of the present invention arethat the test soil device is easier and safer to handle. In addition, itis quick and easy to visually inspect the device after the washing andcleaning processes to ensure that the processes have been successful.The holder means allows the test soil device to be easily located andmaintained in different positions and at different angles in washingapparatus to provide a more accurate representation of washingconditions throughout the apparatus.

BRIEF DESCRIPTION OF THE DRAWINGS

An embodiment of the present invention will now be described withreference to the accompanying figures, wherein:

FIGS. 1a and 1b are perspective views of holder means according to anembodiment of the present invention in open and closed positions;

FIGS. 2a and 2b illustrate side views of the holder means and test soildevice in open and closed positions respectively;

FIG. 2c is a front view of the holder means in FIGS. 1a -2 b;

FIG. 3 illustrates a test soil device used in the apparatus in FIG. 2 b;

FIGS. 4-6 illustrate the locations of washing test apparatus in washingapparatus in three different examples;

FIGS. 7a-7d illustrate further examples of holder means according to thepresent invention;

FIG. 8a illustrates a blank of an outer member forming the holder meansin one embodiment;

FIGS. 8b-8e illustrates a side view, front view, end view andperspective view of the member in FIG. 8a when formed;

FIGS. 9a-9d illustrate views of an inner member for attachment with theouter member shown in FIG. 8 a;

FIG. 9e is an enlarged view of the top edge of the member shown in FIG.9c ; and

FIG. 10 is a perspective view of the members in FIGS. 8 and 9 joinedtogether in a closed position.

DETAILED DESCRIPTION OF THE INVENTION

Referring to the figures, there is illustrated washing test apparatus 2including a holder 4 and a test soil device 6.

Holder 4 includes first and second members 8, 10 pivotally connected toeach other at pivot point 12. First and second members 8, 10 each have ahandle portion 14, 16 and a test soil device holding portion 18, 20.

A spring 22 is attached to opposing surfaces 24, 26 of handle portions14, 16 which biases the handle portions to a closed position, as shownin FIG. 1b . In this position, the handle portions are a spaced distanceapart and the holding portions 18, 20 are adjacent and parallel to eachother.

First and second members 8, 10 are movable between the closed position,shown in FIG. 1b , to an open position, shown in FIG. 1a , by grippinghandle portions 14, 16 and moving the same towards each other, therebycompressing spring 22 and causing holding portions 18, 20 to move apartabout pivot point 12.

Holding portions 18, 20 include sub-portions 18X, 18Y and 20X, 20Y, thesub portions of each holding portion being substantially perpendicularto each other. Sub-portions 18X and 20X are substantially parallel andadjacent each other in said closed position and sub-portions 20S and 20Yare substantially parallel and adjacent each other in said closedposition. The provision of the sub-portions at different anglesincreases the ease with which the holder can be located in a requiredposition during a washing process and also provides multi-directionalwash testing.

Each of said sub-portions 18X, 18Y, 20X, 20Y is provided with aplurality of apertures 28, 30 arranged in a grid format. When first andsecond members 8, 10 are in a closed position, such that the members areparallel to and in contact or are at least adjacent to each other, theapertures 28 on the first members are substantially aligned withapertures 30 on said second member. However, the apertures 28, 30 can beprovided out of alignment if required.

Test soil device 6 includes sheet material having an upper surface 32and a lower surface (not shown). An indicator 34 is provided on both theupper and lower surfaces in a pre-determined pattern by a printingprocess and allowed to dry onto the sheet material. The indicator 34 isprovided in a contrasting colour to the colour of the sheet material,thereby allowing easy visualisation of the indicator.

The indicator typically includes lipids, polysacharrides and at leasttwo proteins and represents typical substances located on medical orsurgical instruments after use in clinical or laboratory procedures.

In use of the wash test apparatus, the holding portions 18, 20 of holder4 are moved to an open position by applying a compressive force tohandle portions 14, 16. Soil test device 6 is inserted between holdingportions 18, 20 and holder 4 is closed by removing the compressive formon the handle portions, thereby biasing the handle portions and thus theholding portions 18, 20 to a closed position. Device 6 is slightlysmaller in length than the combined lengths of sub portions 18X and 18Yor 20X, 20Y. As such, when holder 4 is moved to a closed position,device 6 is folded adjacent the edge 36, 38 defining sub portions 18X,18Y and 20X, 20Y and follows the contours (which in this example aresubstantially planar) of the sub-portions 18X, 18Y, 20X, 20Y, as shownin FIG. 2b . It is to be noted that a number of separate test soildevices can be provided and positioned adjacent sub-portions 18X, 18Y,20X, 20Y if required.

The indicator 34 is typically provided in a substantially centralportion of the sheet material such that a border is formed around theperiphery of device 6. This border corresponds to the peripheral edge ofholding portions 18, 20 which are not provided with apertures 28, 30.

With the soil test device 6 located between the holding portions 18, 20of holder 4, portions of indicator 34 on both sides of the sheetmaterial are accessible to water and other washing detergents orsubstances via apertures 28, 30. In particular, four surfaces 18Y, 20Y,18X and 18Y facing different directions and positioned at differentorientations are presented for washing in this example, therebyproviding a more accurate indication as to the efficacy of the washingprocess than conventional uni-directional devices.

The holder can be located at any required position in the washingapparatus as required. The provision of different angled surfaces allowsthe holder to be positioned and balanced in a required position withgreater ease than conventional devices.

The holder is typically made from stainless steel, in order to simulatethe typical specific heat capacity of surgical instruments and othermedical devices, and also to reduce the risk of damage to the same as aresult of use of extreme washing conditions or detergents.

Once the washing process has taken place, a user can quickly and easilyremove the soil test device from the holder 4 by moving the holder to anopen position. If the washing/cleaning process has been successful, theindicator 34 will be absent from the device. If the washing/cleaningprocess has been unsuccessful, the indicator will still be present onthe device.

Further examples of holder means according to the present invention areillustrated in FIGS. 7a-7d . In FIGS. 7a and 7b , a substantiallycylindrical holder means 202 is provided and includes a first outercylindrical member 204 and a second inner cylindrical member 206. Secondmember 206 is slidably located in the channel 208 defined by walls 210of first member 204 between a first position, wherein member 206 issubstantially encased by first member 204, as shown in FIG. 7a , and asecond position, wherein member 206 is removed in whole or part fromchannel 208 of first member 204 (FIG. 7b illustrates member 206partially removed from first member 204). Test soil device 212 islocated and secured between the first and second members 204, 206 whenin the first position, as shown in FIG. 7a . Apertures 214 can beprovided on both the inner and outer members 204, 206 as required. Theholder means according to this embodiment allows the washing efficiencyto be tested over its 360 degree perimeter. The first and second memberscan also be tapered if required. The holder means shown can include ahandle or gripping portion if required, although one is not shown forthe purposes of clarity.

FIG. 7d , illustrates a hollow spherical holder means 216 wherein thewashing efficiency in substantially all directions can be tested. Inthis example, first and second member can be hemispherical in shape andhinged or detachably attached along at least an arc of the outer surfacethereof, the test soil device typically being located in the sphere 216.Alternatively, the first member can be in the form of an outer sphereand the second member can be in the form of an inner sphere located inthe outer sphere in use. The first member typically has means forseparating portions of the sphere to allow the second member to belocated therein. The test soil device in this example is typicallylocated between the outer and inner spheres.

Referring to FIG. 7c , a holder means 218 is provided wherein the testsoil device holding portion 220 of the first and second members 222, 224is substantially semicircular in shape. The test soil device 226 islocated between the first and second members in the normal manner.

An example of use of the washing test apparatus in a washing processwill now be described with reference to FIG. 4. The washing apparatus isin the form of a washer disinfector consisting of four shelves 102, 104,106, 108, each shelf having a spray arm for spraying cleaning fluid intothe apparatus.

The washing cycle used in the first example includes the followingsteps:

-   -   Pre-rinse with cold water for 2 minutes    -   Drain    -   Main Wash at 60° C. for 3 minutes    -   Drain    -   Rinse for 1 minute with warm water    -   Drain    -   Rinse for 1 minute with warm water    -   Drain

A plurality of test soil devices are located in holders and loose on thefour shelves throughout the washing apparatus. Test soil devices inholders/clips are provided with reference numerals 1-3, 5-6 and testsoil devices located directly onto the shelves in the washing apparatusare provided with reference numerals 4, 7-12. It was found that theindicators of all test soil devices were washed off except those of testsoil devices 2, 5 and 6. Sample 12 also had indicator left thereon inthe region where the test soil device was stapled together. As such,this provides a clear indication to a user that certain regions of thewashing apparatus provide a greater washing/cleaning efficacy than otherregions. This is important to know so that surgical and medicalinstruments in all regions of the washing apparatus are adequatelywashed or cleaned.

In a second example, the washing process was repeated but a detergentwas added in the main wash at 40° C. at a dosage of 5-10 ml per Liter.The washing apparatus typically holds 15 liters of water and thus 100 mlof detergent was used in the process. All soil test devices were locatedin holders and positioned in the washing apparatus on their sidesaccording to FIG. 5 so that the mesh or apertures of the holder facedthe chamber wall of the washing apparatus. It is generally acknowledgedthat areas of the load facing the chamber walls may be more difficult toclean than areas of the load directly facing spray arms or jets.

It was found that samples 2, 3 and 4 all had indicator residue clearlyvisible after the washing process and samples 5 and 6 had smallquantities of indicator residue remaining Sample 1 had no indicatorresidue remaining. These results were in line with expectations of thecleaning performance in this particular machine.

In a third example, the washing process was repeated with the followingsteps:

-   -   Pre-rinse with hot water at 60° C. for 2 minutes    -   Drain    -   Main Wash at 60° C. for 3 minutes    -   Drain    -   Rinse for 1 minute with warm water    -   Drain    -   Rinse for 1 minute with warm water    -   Drain

Detergent was used in the washing process at the same dosage as inexample 2 and at the same temperature. After the pre-wash at 60° C., thetemperature of the water dropped to 30° C. due to lack of hot water andthe water was then slowly increased for about 3.5 minutes to 60° C.before the main wash stage commenced. The soil test devices were onceagain all provided in the holders and were positioned facing the chamberwalls of the washing apparatus in accordance with FIG. 6.

The results of this third washing process showed that all indicatorswere still present and visible on the test soil devices.

It can therefore be seen that the apparatus of the present invention canbe used to provide a reliable test for the level and degree of washingtaking place in the washing apparatus under different washing conditionsand at different locations in the washing apparatus. This is extremelyimportant since different contaminants require washing at differenttemperatures, such as proteins which, if not washed at a temperaturebelow 35° C., become denatured and become extremely difficult to remove.

Referring to FIGS. 8a-8e , there is illustrated a blank 302 of a memberin one embodiment of the present invention. The blank 302 includes afirst arrangement of apertures 304 arranged in a grid format adjacentend 306 and a second arrangement of apertures 308 arranged in a gridformat. A border is provided around each arrangement of apertures.Apertures 308 are provided a spaced distance apart from apertures 304and an aperture 310 provided at end 312. The blank can be formed into arequired shape according to any conventional method, such as bendingand/or the like. The apertures are typically cut by nitrogen lasercutting but other conventional techniques can also be employed.

FIGS. 8b-8e illustrate the member when formed and end 306 is bent sothat apertures 304 are substantially perpendicular to apertures 308. Afurther substantially identical member 302′ (FIGS. 9a-9e , the samefeatures are identified by a ′) can then be attached to member 302 bymeans of an attachment, such as a portion of sprung metal or a metalclip 318 as shown in FIG. 10, which is typically attached to one of themembers and located through aperture 310 and 310′ on the other of saidmembers. This clip or portion can also act as biasing means if required.A slot or recess 314 can be provided to allow the attachment of one endof the sprung metal or clip therein. Member 302 typically forms theouter member and member 302′ typically forms the inner member when saidmembers are joined together.

FIGS. 9a-9e illustrate various views of the further member 302′ formedaccording to a different arrangement to that illustrated in FIGS. 8a-8e. In this arrangement, end 312′ has been bent relative to the surface ofmember 302′ on which apertures 308′ are provided, in addition to bendingof end 306′ to form a handle portion. In the final arrangement, end 312′faces inwardly of the member towards end 306′. A pivot point or fulcrum314′ is provided in the form of a bridge or protruding portion to allowmember 302′ to pivot with respect to member 302.

Members 302 and 302′ are arranged in a substantially overlappingarrangement when joined together in a first closed position, andapertures 304, 308 are substantially aligned and adjacent each other.Portion 316′ is a spaced distance apart from portion 316, therebyallowing portion 316′ to be gripped by a user in use and moved towardsportion 316. The clip 318 joining members 302 and 302′ together allowsmember 302′ to pivot away from member 302, thereby allowing a test soildevice to be located therebetween and/or removed.

The holder of the present invention can be provided in any requiredshape, size and/or design and can present a variety of surfaces whichdiffer in number, direction or orientation as required, therebyproviding a more stringent test for decontamination processes than priorart devices. The test soil devices of the present invention can be usedalone if required to provide an indication as to the spray and jetpatterns within the washing apparatus. The test soil devices can also besuspended in ultrasonic cleaners to allow identification of lowultrasonic activity. Furthermore the flexibility of the sheet materialfrom which the test soil devices are formed allows the same to be rolledinto a substantially cylindrical shape for location in tubes or toreflect the degree of washing in tubes and other lumen or channelcontaining instruments. The advantage of rolling the indicator sheetmaterial into a tube is that the indicator sheet material may besubsequently unrolled after the process. This allows visual examinationof the internal surfaces of a narrow bore or lumen, which would notnormally be possible by conventional means.

The invention claimed is:
 1. A three-piece test-strip holder for use ina medical washer, said holder comprised of: (a) an outer member formedfrom an elongated, generally rectangular flat first blank, said outermember having, a transverse slot formed width-wise across said firstblank, a plurality of spaced-apart apertures formed through said firstblank, said apertures disposed to a first side of said slot, an openingformed through said first blank disposed to a second side of said slot,and a first end of said first plate bent to form a generally L-shapedsection, said L-shaped section disposed to said first side of said slot;(b) an inner member formed from an elongated, generally rectangular flatsecond blank, said inner member having, an elongated protrusion formedwidth-wise across said second blank, a plurality of apertures formedthrough said second blank, said apertures disposed to a first side ofsaid protrusion, an opening formed through said second blank disposed toa second side of said protrusion, a first end of said second blank bentto form a generally L-shaped section, said L-shaped section disposed tosaid first side of said protrusion and dimensioned to conform to saidL-shaped section of said first blank; and a second end of said secondblank bent toward said first end of said second blank; and (c) a springmetal clip extending through said openings in said first and secondblanks, said clip joining said outer member to said inner member,wherein said L-shaped first ends of said first and second blanks arebiased together into overlapping mating contact, wherein said protrusionon said second blank forms a pivot between said first and second blanks,and wherein said second end of said second blank and a second end ofsaid first blank are spaced-apart.
 2. A test-strip holder according toclaim 1, wherein said first and second blanks are formed of stainlesssteel.
 3. A test-strip holder according to claim 1, wherein said firstand second blanks have like dimensions.
 4. A test-strip holder accordingto claim 3, wherein said lateral edge of said first and second blanksare aligned when said first and second blanks are joined by said clip.5. A test-strip holder according to claim 1, wherein said generallyL-shaped section of said first and second blanks are formed byperpendicular surfaces.
 6. A test-strip holder according to claim 1,wherein said plurality of apertures are provided in a grid-likearrangement.
 7. A test-strip holder according to claim 6, wherein saidapertures are square.
 8. A test-strip holder according to claim 6,wherein said apertures in said L-shaped sections of said first andsecond blanks are generally aligned when said L-shaped sections areoverlapping and mating.
 9. A test-strip holder according to claim 1,wherein a free end of said clip is received in said recess.
 10. Atest-strip holder for use in a medical washer, said holder comprised of:(a) a first metallic plate having, an elongated slot formed therein, aplurality of spaced-apart apertures formed through said first plate,said apertures disposed to a first side of said slot, an opening formedthrough said first plate to a second side of said slot, and a first endof said first plate bent to form a contoured section that is disposed tosaid first side of said slot; (b) a second metallic plate having, anelongated protrusion formed on a surface thereof, a plurality ofapertures formed through said second plate, said apertures disposed to afirst side of said protrusion, an opening formed through said secondplate to a second side of said protrusion, a first end of said secondplate bent to form a contoured section to said first side of saidprotrusion, said contoured section of said second plate dimensioned toconform to said contoured section of said first plate; and a second endof said second plate bent toward said first end of said second plate;and (c) a spring metal clip extending through said openings in saidfirst and second plates, said clip joining said plates together andhaving one end received in said slot, wherein said elongated protrusionis disposed between said first and said second plates and forms a pivottherebetween, wherein said contoured ends of said first and secondplates are biased together into overlapping mating engagement, andwherein said second end of said second plate and a second end of saidfirst plate are spaced-apart.
 11. A test-strip holder according to claim10, wherein said first and second plates are rectangular in shape andhave like dimensions.
 12. A test-strip holder according to claim 11,wherein said first and second plates are stainless steel.
 13. Atest-strip holder according to claim 10, wherein said contoured sectionsof said first and second plates are L-shaped.
 14. A test-strip holderaccording to claim 13, wherein said L-shaped sections are formed byperpendicular surfaces.
 15. A test-strip holder according to claim 10,wherein said contoured sections are rounded.
 16. A test-strip holderaccording to claim 10, wherein said apertures are provided in agrid-like arrangement.